Cognitive-behavioral and pharmacologic interventions for hyperactive boys: Comparative and combined effects

Assessed the effects of 2 interventions--reinforcement and reinforced self-evaluation--on the positive social behavior of 24 8-13 yr old hyperactive males to test the hypothesis that reinforced self-evaluation would produce greater positive social behavior in Ss. Comparisons between Ss receiving methylphenidate (5-40 mg/day) and Ss receiving placebo were also conducted to clarify the effects of stimulant medication on Ss' social behavior. The primary outcome measures were direct observations of appropriate and negative social interactions. Results indicate that both methylphenidate and reinforced self-evaluation were superior to the contrast treatments. When the effects of the 4 treatment combinations were rank ordered, medication plus cognitive-behavioral self-evaluation proved optimal; placebo plus reinforcement alone was significantly worse than all other conditions. Medication enhanced the accuracy of Ss' self-evaluation. Findings are discussed in the context of the need for intervention with the social and interpersonal difficulties of hyperactive children. (46 ref)